Board Certified Nutrition Support Pharmacist (BCNSP)
Verified Exam COMPLETE QUESTIONS AND
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What is the max you should increase the serum Na per
hour and/or per day? - Answer-0.25 - 0.5 mEq/hr or 6-12
mEq/day
How do you calculate Na Deficit? - Answer-(0.6 x kg) x
(140 - Measured Na)
In which cases should you use hypertonic (3%) saline?
How often should you redraw labs? When should you
stop? - Answer-1. If there is CNS dysfunction involved or a
decrease in end organ perfusion.
2. Draw labs every 1 -2 hours
3. stop once Na gets > 125
What can a rapid infusion on Na Cause? - Answer-
Osmotic Myelinolysis
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What are the sy/sx of Na less than 125, less than 115 -
Answer-less than 125 headache, muscle weaknedd,
nausea, confusion less than 115: death, seizure, scoma
What are the causes of SIADH? - Answer-1. Tumors 2.
Cranial Damage 3. Lung Disorders 4. Medications
What happens in SIASH - Answer-Increase in ADH with
leads to reabsoption in kidney and hypovolemic
neutropenia
How do you calculate serum osmolality? - Answer-2xNa +
glucose/18 + BUN/2.8
What are some causes of 1. primary Hyponatremia 2.
secondary hyponatremia? - Answer-Primary
1. GI Loss
2. Fistula drainage
3. Diurtic overuse
4. Adrenal inssuficentcy
Secondary
1. hypertonic saline
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2. over drinking of h2o
3. increased ADH (cussings)
1. Daily adequate intake of Sodium? Renal Reabsorption
efficient? - Answer-1. 1500mg or 65 mEq/day
2. less than 1mEq/L
How do you calculate water deficit? - Answer-(0.6 x kg) x
(Na - 140)/140. Replace half over the first 24 hours.
What is the absorption capacity of the small bowel? -
Answer-9-12L/day
How many Meqs of sodium are in 1L saline and LR? -
Answer-154 and 130
Corrected Ca formula - Answer-Corrected Ca = Ca + (0.8
x (4-alb))
What are the normal K+/day for adults? How much will
rase blood work 1mEq? - Answer-normal adults require
40-60 mEq/day
300mg will raise 1mEq
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Tx of hyperkalemia - Answer-1. 10ml of 10% CaGlu over
3-5 min
2. 50 -100 ml of Sodium Bicarb over 10-20 min
3. 100ml of 50% Dextrose
4. 25g of Na Polysterene Sulfate in 20 Sorbitol
5. IV Saline + Furosimide
6. Hemodialysis
Which is more dangerous Hyperkalemia or Hypokalemia?
Sx/Sy of both? - Answer-Hyperkalemia is worse can cause
EkG changes, bradycardia, a-systole, v fib
Hyopkalemia can cause paralysis, muscle weakness
What is the adequate intake of K+? - Answer-120 mEq/day
Water deficit? - Answer-0.6 x kg ( na -140/140)
What is the insulin cocktail? - Answer-10ml of 10% ca glu
over 3-5 min
50-100 meq NaHCO3 over 10-20 min